Acute flaccid paralysis surveillance indicators in the Democratic Republic of Congo during 2008-2014.

“Of the 13,749 AFP cases investigated, 58.9% received at least three doses of oral polio vaccine (OPV), 7.3% never received OPV, while the status of 18.3% was unknown.” Pan African Medical Journal 2016
https://www.ncbi.nlm.nih.gov/m/pubmed/27642491


Acute maternal anterior poliomyelitis in a non-endemic zone.

“The authors report the case of a 26 year old woman with acute anterior poliomyelitis contracted during the vaccination of her baby. Despite having been herself vaccinated in infancy she was not protected against the poliovirus. The clinical interest of this uncommon case is a severe paralytic state with definitive paraplegia.” Acta Neurologica Belgica 1989
https://www.ncbi.nlm.nih.gov/m/pubmed/2561040


Antibodies to human myelin proteins and gangliosides in patients with acute neuroparalytic accidents induced by brain-derived rabies vaccine.

“Antibody responses to myelin antigens were analysed in 15 patients who developed acute neuroparalytic accidents (ANPA) during post-exposure rabies vaccination using a rabies vaccine prepared on brain tissues and in 30 individuals who were uneventfully vaccinated.” Journal of Neuroimmunology 1989
https://www.ncbi.nlm.nih.gov/m/pubmed/9846820


ANTIRABIES ANTIBODY RESPONSE IN MAN TO VACCINE MADE FROM INFECTED SUCKLING-MOUSE BRAINS.

“Antirabies vaccines produced from infected brains of adult mammals have always had the potentiality of causing post-vaccinal paralysis or allergic encephalitis in man. Attempts in recent years either to remove the paralytic factor from brain-tissue vaccines or to use as the virus source infected tissue other than nervous tissue (e.g., chick embryos) have usually resulted in a substantial reduction of the specific antirabies potency.” Bulletin of the World Health Organization 1964
https://www.ncbi.nlm.nih.gov/m/pubmed/14163964/


A case of Guillain-Barré syndrome following cholera vaccination (author’s transl)

“A 45-year-old woman developed bilateral ascending flaccid paralysis after cholera vaccination, 15 days after the first and 1 day after the second injection. The clinical course resulted in nearly complete paralysis of the lower limbs, paresis of the upper limbs and partial involvement of the cranial nerves. There was only slight sensory loss. The CSF revealed no pleocytosis and a protein level of 206 mg/100 ml. Recovery began 2 weeks later and was almost complete after 2 months. Immunological investigations revealed no remarkable changes.” Journal of Neurology 1975
https://www.ncbi.nlm.nih.gov/m/pubmed/50424/


Case report of post sheep brain rabies vaccine neuroparalytic complications at Tikur Anbessa Teaching Hospital, in Ethiopia.

“We report four cases of ascending paralysis admitted to Tikur Anbessa Specialized Hospital (TASH) within six months period between December 2010 and June 2011 following administration of sheep brain tissue anti rabies vaccine for presumed rabies exposure. The paralysis started after a minimum of twelve doses of the vaccine. Two of the patients were discharged with severe paralysis and two died in the hospital.” Ethiopian Medical Journal 2011
https://www.ncbi.nlm.nih.gov/m/pubmed/23409403/


Characteristics of poliovirus strains from long-term excretors with primary immunodeficiencies.

“Individuals who are deficient in humoral immunity are particularly at risk from infection with enteroviruses, and poliovirus in particular, where antibodies are the main source of protection from disease. Long-term excretion of vaccine strains of poliovirus has been documented for many years and instances of paralytic poliomyelitis in hypogammaglobulinaemic patients who were subsequently found to have been excreting virus for prolonged periods have been reported in the U.S.A., Germany and Japan. The identification of a healthy immunodeficient patient in the U.K. who has probably been excreting type 2 poliovirus for 15 years will be described, with the characteristics of the virus and the results of attempts at treatment so far. Such individuals pose a significant risk to the eradication programme unless they can be identified and treated.” Developments in Biologicals 2001 https://www.ncbi.nlm.nih.gov/m/pubmed/11763340


Guillain-Barré Syndrome after H1N1 Shot in Pregnancy: Maternal and Fetal Care in the Third Trimester-Case Report.

“We presented a case of a 36-year-old pregnant woman that was immunized to H1N1 in the last trimester; 10 days later she developed shoulder and lumbar spine’s pain, limbs weakness and facial paralysis with unfavorable clinical evolution and was submitted to intensive therapy care. We described clinical and obstetrical approach, pointing out peculiarities involved in this pathology in pregnancy.” Case Reports in Obstetrics and Gynecology 2014
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3521405/


Guillain – Barre’ syndrome following recombinant hepatitis B vaccine and literature review.

“A 17 year-old woman developed progressive quadriparesis with bilateral facial diplegia after immunization with recombinant hepatitis B vaccine 3 days prior. Cerebrospinal fluid analysis revealed acellular fluid with high protein level. The electrodiagnosis was compatible with demyelinating polyneuropathy. Other potential causes of Guillain-Barre’ syndrome (GBS) were ruled out. Her motor power gradually improved and returned to normal later. The temporal relationship between GBS and vaccination was suggestive of a vaccine-induced cause. Mechanisms of this very rare complication are proposed with a literature review.” Journal of the Medical Association of Thailand 2000
https://www.ncbi.nlm.nih.gov/m/pubmed/11075984/


Imported Vaccine-Associated Paralytic Poliomyelitis — United States, 2005

“This report describes the first known occurrence of imported VAPP {vaccine-associated paralytic polio} in an unvaccinated U.S. adult who traveled abroad, where she likely was exposed through contact with an infant recently vaccinated with OPV.” CDC 2005
https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5504a2.htm
https://www.ncbi.nlm.nih.gov/m/pubmed/16456525/


LESSONS FROM THE SALK POLIO VACCINE: METHODS FOR AND RISKS OF RAPID TRANSLATION

The Salk inactivated poliovirus vaccine is one of the most rapid examples of bench‐to‐bedside translation in medicine. In the span of 6 years, the key basic lab discoveries facilitating the development of the vaccine were made, optimization and safety testing was completed in both animals and human volunteers, the largest clinical trial in history of 1.8 million children was conducted, and the results were released to an eagerly awaiting public. Such examples of rapid translation cannot only offer clues to what factors can successfully drive and accelerate the translational process but also what mistakes can occur (and thus should be avoided) during such a swift process.Clinical and Translational Science 2010 Clinical and Translational Science 2010 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2928990/


Mechanism of Injury-Provoked Poliomyelitis

“Skeletal muscle injury is known to predispose its sufferers to neurological complications of concurrent poliovirus infections. This phenomenon, labeled “provocation poliomyelitis,” continues to cause numerous cases of childhood paralysis due to the administration of unnecessary injections to children in areas where poliovirus is endemic. Recently, it has been reported that intramuscular injections may also increase the likelihood of vaccine-associated paralytic poliomyelitis in recipients of live attenuated poliovirus vaccines.”  Journal of Virology 1996
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC110068/


MRI findings in an infant with vaccine-associated paralytic poliomyelitis.

“We report a Brazilian infant who developed VAPP 40 days after receiving the first dose of oral polio vaccine (OPV). MR images of the cervical and thoracic spinal cord showed lesions involving the anterior horn cell, with increased signal intensity on T2-weighted sequences. We would like to emphasize the importance of considering VAPP as a differential diagnosis in patients with acute flaccid paralysis and an MRI showing involvement of medulla oblongata or spinal cord, particularly in countries where OPV is extensively administered.” Pediatric Radiology 2010
https://www.ncbi.nlm.nih.gov/m/pubmed/20440488/


The muscle findings in a pediatric patient with live attenuated oral polio vaccine-related flaccid monoplegia

“This patient was diagnosed as live attenuated oral polio vaccine-related flaccid monoplegia, with mild clinical course.” Vaccine 2014
https://www.ncbi.nlm.nih.gov/m/pubmed/25131733/


Neonatal paralytic poliomyelitis. A case report.

“We report a child who became symptomatic with apnea at 18 days of age and who subsequently developed a permanent monoparesis. Serologic and cultural evidence indicated the virus as poliovirus vaccine type. Another infant who received live oral poliovirus vaccine was probably the source of the infecting virus.” Archives of Neurology 1986
https://www.ncbi.nlm.nih.gov/m/pubmed/3947264/


Neurologic complications due to a sample type of rabies vaccination

“Neuroparalytic accidents due to sample type rabies vaccination are still an important problem in our country. We present seven patients with ascending polyneuritis, due to rabies vaccine, treated between 1982-1986, and discuss the importance of the problem.” Mikrobiyoloji Bulteni 1987
https://www.ncbi.nlm.nih.gov/m/pubmed/3447020/


Neurologic complications in oral polio vaccine recipients

“A vaccine-like strain of poliovirus was isolated from each patient, and each had symptoms (left leg paralysis in three; developmental regression, spasticity, and progressive fatal cerebral atrophy in one) persisting for at least 6 months.” Journal of Pediatrics 1996 https://www.ncbi.nlm.nih.gov/m/pubmed/3012055/


Neuroparalytic accidents of antirabies vaccination with suckling mouse brain vaccine. Clinical and pathologic study of 21 cases

“Twenty-one cases of neuroparalytic accidents of rabies vaccination (with suckling mouse brain vaccine), 11 of them fatal, were observed, occurring predominantly in men; the mean age of the patients was 29 years.” Archives of Neurology 1977
https://www.ncbi.nlm.nih.gov/m/pubmed/911231/


A novel vaccinological evaluation of intranasal vaccine and adjuvant safety for preclinical tests.

“However, the addition of adjuvants to vaccines may cause unwanted immune responses, including facial nerve paralysis and narcolepsy. ” Vaccine 2016 https://www.ncbi.nlm.nih.gov/m/pubmed/28063707/


Outbreak of poliomyelitis in Hispaniola associated with circulating type 1 vaccine-derived poliovirus.

“An outbreak of paralytic poliomyelitis occurred in the Dominican Republic (13 confirmed cases) and Haiti (8 confirmed cases, including 2 fatal cases) during 2000-2001. All but one of the patients were either unvaccinated or incompletely vaccinated children, and cases occurred in communities with very low (7 to 40%) rates of coverage with oral poliovirus vaccine (OPV). The outbreak was associated with the circulation of a derivative of the type 1 OPV strain, probably originating from a single OPV dose given in 1998-1999. The vaccine-derived poliovirus associated with the outbreak had biological properties indistinguishable from those of wild poliovirus.” Science 2002
https://www.ncbi.nlm.nih.gov/m/pubmed/11896235/


Paralytic poliomyelitis associated with the Sabin 3 revertant strain of poliovirus in Bahrain.

“We report a case of vaccine-associated paralytic poliomyelitis (VAPP) in Bahrain. The case occurred in an 8-week-old infant who had received a dose of oral polio vaccine (OPV) 7 days after birth.” Annals of Tropical Paediatrics 2002 https://www.ncbi.nlm.nih.gov/m/pubmed/11579860


Polio eradication in India: some observations.

“Oral polio vaccine (OPV) has failed to provide full protection to many children who have developed paralytic polio even after taking 10 or more doses of OPV. In some children, OPV has caused paralysis-vaccine associated paralytic polio (VAPP). Number of children developing polio due to vaccine is high and on increase.” Vaccine 2004
https://www.ncbi.nlm.nih.gov/m/pubmed/15532129


Paralytic Disease in the Father of a Recently Immunized Child

“Paralytic poliomyelitis was diagnosed clinically in a 29-year-old man three weeks after his 2-year-old son received trivalent live oral poliovirus vaccine. Type 2 poliovirus with “vaccine-like” characteristics was isolated from the patient’s stool, and the serum showed a significant rise in neutralizing antibody against type 2 virus. There was no rise in complement fixation antibody titers. The patients illness was likely due to type 2 poliovirus contracted from his son. Physicians should inquire about the immunization status of parents before administering vaccine to children.” JAMA 1967
http://jamanetwork.com/journals/jama/article-abstract/335320


Sudden hearing loss after rabies vaccination.

CONCLUSION: This study presents a case report of sudden hearing loss developing after rabies immunisation – no other aetiological factors were detected and clinical management is discussed in light of the literature.” Balkan Medical Journal 2013
https://www.ncbi.nlm.nih.gov/m/pubmed/25207131/


Update on vaccine-derived polioviruses–worldwide, July 2009-March 2011.

“Despite its many advantages, OPV use carries the risk for occurrence of rare cases of vaccine-associated paralytic poliomyelitis among immunologically normal OPV recipients and their contacts and the additional risk for emergence of vaccine-derived polioviruses (VDPVs).” CDC 2011
https://www.ncbi.nlm.nih.gov/m/pubmed/21716199/


Use of a novel real-time PCR assay to detect oral polio vaccine shedding and reversion in stool and sewage samples after a mexican national immunization day.

“During replication, oral polio vaccine (OPV) can revert to neurovirulence and cause paralytic poliomyelitis. In individual vaccinees, it can acquire specific revertant point mutations, leading to vaccine-associated paralytic poliomyelitis (VAPP). With longer replication, OPV can mutate into vaccine-derived poliovirus (VDPV), which causes poliomyelitis outbreaks similar to those caused by wild poliovirus. After wild poliovirus eradication, safely phasing out vaccination will likely require global use of inactivated polio vaccine (IPV) until cessation of OPV circulation.” Journal of Clinical Microbiology 2011
https://www.ncbi.nlm.nih.gov/m/pubmed/21411577


Vaccine-associated contact paralytic poliomyelitis with atypical neurological presentation.

“Paralytic poliomyelitis presenting with quadriparesis, transient encephalitis and bulbar symptoms in 2 patients in close contact with recently vaccinated children with trivalent live oral polio vaccine is described.” Acta Neurologica Scandinavica 1987
https://www.ncbi.nlm.nih.gov/m/pubmed/3687370/


Vaccine-associated paralytic poliomyelitis: a case report of domiciliary transmission.

“We herein present the case of an unvaccinated child, with a clinical picture of an acute anterior poliomyelitis associated with the live strain vaccine, whose brother received the Sabin vaccine 20 days before the onset of the symptoms. Vaccine strain of the type 3 poliovirus was isolated in fecal culture and a presented mutation in nucleotide 472 (C–>U) in the 5′ non-coding region, which is strongly related to the higher strain virulence.” Rev Hosp Clin Fac Med Sao Paulo 2002
https://www.ncbi.nlm.nih.gov/m/pubmed/10983013/


Vaccine-associated paralytic poliomyelitis caused by contact infection.

“We encountered an adult patient with acute anterior poliomyelitis (AAP), whose monoparesis developed 28 days after his son’s immunization with oral poliovirus vaccine (OPV).” Internal Medicine Journal 2006
https://www.ncbi.nlm.nih.gov/m/pubmed/16617188/


VACCINE-ASSOCIATED POLIOMYELITIS IN A CHILD WITH THYMIC ABNORMALITY

“An 8-month-old girld develoepd paralytic poliomyelitis. Twenty-nine days prior to the onset of paralysis she had been in contact with a sibling recently immunized with trivalent oral polio vaccine.” American Academy of Pediatrics 1971
http://pediatrics.aappublications.org/content/48/6/923


Vaccine-induced polioencephalomyelitis in Scotland.

“A six-month-old British female, living in Glasgow was admitted in June 1986 with a four-day history of fever and lower limb weakness following immunisation with oral polio and triple (DTP) vaccines. Examination revealed paralysis of all limbs, facial muscles and right diaphragm, scoliosis, opsoclonus and ocular flutter. Poliovirus types 1, 2 and 3, isolated from her stool specimens were all vaccine-like strains.” Scottish Medical Journal 1988
https://www.ncbi.nlm.nih.gov/m/pubmed/2847313/

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